Erythema multiforme

Erythema multiforme is a skin reaction that can be triggered by an infection or medication. It’s usually mild and goes away in a few weeks. 

The rash comes on suddenly and develops over a few days. It tends to start on the hands or feet, before spreading to the limbs, upper body and face. The rash:

  • starts as small red spots, which may become raised patches a few centimetres in size
  • often has patches that look like a target or “bulls-eye”, with a dark red centre that may have a blister or crust, surrounded by a pale pink ring and a darker outermost ring
  • may be slightly itchy or uncomfortable
  • usually fades over two to four weeks

In more severe cases, the patches may join together to form large, red areas that may be raw and painful. It can sometimes be associated with headache, temperature, red eyes, mouth ulcers, painful & swollen joints and swollen lips. See your GP as soon as possible if your child may have erythema multiforme. If you’re unable to see a GP, contact your local out of hours service or NHS 111 for advice.

Most cases are caused by a viral infection – often the herpes simplex virus. This virus usually lies inactive in the body, but it can become reactivated from time to time. It can also be triggered by mycoplasma bacteria, a type of bacteria that sometimes cause chest infections. Medication can occasionally cause the more severe form of erythema multiforme. Possible medication triggers include:

Treatment aims to tackle the underlying cause of the condition, relieve your symptoms and stop your skin becoming infected. Treatment may include:

  • stopping any medication that may be triggering your symptoms – do not try this without speaking to your doctor first
  • antihistamines and moisturising cream to reduce itching
  • steroid cream to reduce redness and swelling (inflammation)
  • painkillers for any pain
  • antiviral tablets, if the cause is a viral infection
  • anaesthetic mouthwash to ease the discomfort of any mouth sores

Reference : NHS Choices

Target lesion

Permission for picture taken from the child and his parents. He wanted his hand to be famous 😉